Care home fees

We are all worried that as we or our elderly relatives grow old, we or they may need to go into a care home. Fees for care homes are very high, and if somebody spends their last few years in a home, their savings will be greatly diminished.

Where a persons care need is primarily a health care need, the responsibility for financing the care falls to the NHS irrespective of that persons capital. Those who have complex and intense health needs, such as breathing difficulties, swallowing difficulties, inability to communicate and express needs, high level of confusion or are prone to infections may be assessed as eligible for NHS Continuing Care Funding. Many people will not be entitled to this funding because they either don’t require nursing care or their need for care is incidental to their need for accommodation and personal care. Even then, however, the NHS has a duty to pay for the cost of providing nursing care by a registered nurse in a nursing home. You may find that even if the NHS won’t pay the whole of the cost of the home, they may make a contribution.

Where a persons health care need is only incidental to the provision of accommodation, the local authority is responsible for payment of care home fees, subject to that persons income and capital.

If you stay in a care home for more than 12 weeks and you have capital of more than £22,000 (including equity in your home), you may have to pay all of your own fees. Even if you have less than £22,000 capital a great deal of your income may be used to pay the fees. If you go into a home, your house may have to be sold in order to pay the fees, unless the house is occupied by your partner, or by another relative aged over 60 or under 16, or by a disabled relative.

If you don’t have capital, the local authority will fund the majority of the fees. In such cases, the local authority will consider the resident’s wishes regarding the choice of accommodation, provided that the accommodation and cost are reasonable. If you want to go into a more expensive home than the local authority will normally pay for, you or your family may pay a “top up” fee.

If the NHS assesses you and says that you do not need NHS Continuing Care, you can challenge that decision by having an independent assessment. The ultimate decision about who pays, or how much can be paid by the NHS is likely to depend on your overall health needs. With so much money at stake it is worth seeking medical and legal advice to see whether the NHS should pay all or some of the fees.